MAJOR SALIVARY-GLAND DYSFUNCTION IN HUMAN ACUTE AND CHRONIC GRAFT-VERSUS-HOST DISEASE (GVHD)

Salivary gland dysfunction is frequently observed in patients sufferin g from acute (a) and chronic (c) GVHD. We studied the influence of GVH D on the function of major salivary glands in 20 patients with GVHD (c GVHD, 15; aGVHD, 5), A subjective evaluation of salivary function was performed, in which the score ranged from 0-4 where a higher score ind icated more oral dryness, Patients with aGVHD scored 4.0 while patient s with cGVHD scored 2.1 (P < 0.01), In addition to this subjective eva luation, patients' salivary flow rates were measured and a reduction o f 90% and 60% in aGVHD and cGVHD patients respectively, was observed a s compared to controls (P < 0.01; P < 0.05), No hyposalivation was obs erved in patients who underwent bone marrow transplantation but did no t develop GVHD as compared to normal individuals, A direct correlation was observed between the degree of hyposalivation and the severity of the GVHD. Hyposalivation was also documented by scintigraphy of the m ajor salivary glands in the GVHD patients, Furthermore, hyposalivation was associated with extensive mucosal atrophy, erythema, tongue surfa ce depapillation, lichenoid lesions of the buccal and labial mucosa as well as lupus-like lesions, Routine assessment of these glands in pat ients with GVHD could play a role in monitoring response to therapy.